[A retrospective study of 129 cases with immediate breast reconstruction after skin-sparing mastectomy for breast cancer].
OBJECTIVE
To evaluate the oncologic safety, indications and aesthetic results for skin-sparing mastectomy (SSM) and immediate breast reconstruction (IBR).


METHODS
One hundred and twenty-nine breast cancer patients treated by SSM + IBR from October 1999 to May 2007 were reviewed. Reconstructive techniques included latissimus dorsi flaps (38 patients), implants only (2 patients), latissimus dorsi flaps plus implants (61 patients), pedicled transverse rectus abdominis myocutaneous (TRAM) flaps (25 patients) and deep inferior epigastric artery perforator (DIEP) flaps (3 patients). Aesthetic results were judged by patients' self-evaluation.


RESULTS
Mean duration of hospitalization was 18.6 days. Time of first chemotherapy was 5.2 days after operation. Eleven patients (11/63, 17.5%) developed capsular contracture and 24 patients (24/99, 24.2%) developed seroma in the donor site. Nine patients (9/28, 32.1%) developed partial fat necrosis in TRAM and DIEP flaps. The satisfaction with the aesthetic results of the reconstructive breast was significantly lower in irradiated patients than non-irradiated ones. Median follow-up time was 11 months. Five patients developed local recurrence and 7 patients with metastasis.


CONCLUSIONS
SSM with IBR can be used for the 0 to II a stage breast cancer patients, with surgical oncologic and aesthetic satisfaction. Radiotherapy has an adverse effect on the reconstructive breast. Delayed or delayed-immediate reconstructions are recommended for patients indicated to postoperative radiotherapy.
Wu
Jiong
J
Department of Breast Surgery, Cancer Hospital, Fudan University, Shanghai 200032, China. wujiong1122@vip.sina.com
Di
Gen-Hong
GH
Chen
Tian-Wen
TW
Qi
Fa-Zhi
FZ
Shen
Kun-Wei
KW
Han
Qi-Xia
QX
Shen
Zhen-Zhou
ZZ
Shao
Zhi-Min
ZM
D000328:Adult; D001943:Breast Neoplasms / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016462:Mammaplasty / Q000379:methods*; D015414:Mastectomy, Subcutaneous; D008875:Middle Aged; D012189:Retrospective Studies; D013524:Surgical Flaps; D016896:Treatment Outcome